- Rochester Regional Health (Rochester, NY)
- … Medicare Model: Operate within a globally capitated system under Medicare / Medicaid , allowing you the flexibility to optimize resources for maximized ... patient function. Benefits We Offer: In addition, the pay range noted below may also include productivity and/or value based clinical incentives, bonus compensation, or other forms of variable pay. + Generous Retirement Plans: Secure your future with our… more
- Sodus Rehab & Nursing Center (Cortlandt, NY)
- …+ Participates in internal audits as directed + Possess a strong knowledge of Medicare , Medicaid and other payment sources and their responsibility in the SNF ... resident, staff and family education and in-servicing + Demonstrates working knowledge of Medicare Part A PPS case management + Complies with Federal and State… more
- The Arc Erie County NY (Tonawanda, NY)
- …of the agency, the Office for People With Developmental Disabilities OPWDD, Medicaid , Medicare , insurance companies, municipalities, Department of Health, school ... the Professions, the Office for People With Developmental Disabilities (OPWDD), Medicaid , Medicare , insurance companies, municipalities, Department of Health,… more
- CVS Health (Albany, NY)
- …Experience or willingness to thoroughly learn the role of care management within Medicare and Medicaid managed care. + **Community Resources:** Familiarity with ... of the position. **Preferred Qualifications** + Experience providing care management for Medicare and/or Medicaid members + Experience working with individuals… more
- Molina Healthcare (Rochester, NY)
- …in accordance with the standards and requirements established by the Centers for Medicare and Medicaid Services (CMS). **Essential Job Duties** * Enters denials ... Qualifications** * Customer/provider experience in a managed care organization ( Medicaid , Medicare , Marketplace and/or other government-sponsored program), or… more
- New York State Civil Service (West Seneca, NY)
- …listed as an excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or ... eligible and maintain eligibility for full and unconditional participation in the Medicare and Medicaid programs. Continued employment will depend on maintaining… more
- Molina Healthcare (Buffalo, NY)
- …Common Procedure Coding (HCPC). * Experience demonstrating knowledge of Centers for Medicare and Medicaid Services (CMS) guidelines, MCG, InterQual or other ... medically appropriate clinical guidelines, Medicaid , Medicare , CHIP and Marketplace, applicable state regulatory requirements, including ability to easily access… more
- CVS Health (Albany, NY)
- …years of clinical practice experience. Two (2) + years of experience in managed care ( Medicare and/or Medicaid ) MD or DO; Board certification in an ABMS or AOA ... one state where we have an Integrated plan. Experience with managed care ( Medicare and Medicaid ) utilization review preferred. **Education** MD (Doctor of… more
- Molina Healthcare (Syracuse, NY)
- …with the standards and requirements established by the Centers for Medicare and Medicaid **KNOWLEDGE/SKILLS/ABILITIES** + Responsible for the comprehensive ... including coordination of benefits, subrogation, and eligibility criteria. + Familiarity with Medicaid and Medicare claims denials and appeals processing, and… more
- New York State Civil Service (Bronx, NY)
- …utilization review experience in a health care facility regulated by Centers for Medicare and Medicaid Services Utilization Review Standards, or* Possession of a ... excluded individual or entity on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal or Federally assisted… more